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心脏骤停幸存者的自我报告认知功能及其与自我报告健康状况、心理困扰和生活满意度的关联——一项瑞典全国性登记研究

Cardiac arrest survivors' self-reported cognitive function, and its association with self-reported health status, psychological distress, and life satisfaction-a Swedish nationwide registry study.

作者信息

Larsson Karin, Hjelm Carina, Strömberg Anna, Israelsson Johan, Bremer Anders, Agerström Jens, Carlsson Nina, Tsoukala Dionysia, Nordström Erik Blennow, Årestedt Kristofer

机构信息

Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

出版信息

Resuscitation. 2025 Apr;209:110550. doi: 10.1016/j.resuscitation.2025.110550. Epub 2025 Feb 17.

Abstract

AIM

Self-reported cognitive function has been described as an important complement to performance-based measurements but has seldom been investigated in cardiac arrest (CA) survivors. Therefore, the aim was to describe self-reported cognitive function and its association with health status, psychological distress, and life satisfaction.

METHODS

This study utilised data from the Swedish Register of Cardiopulmonary Resuscitation (2018-2021), registered 3-6 months post-CA. Cognitive function was assessed by a single question: "How do you experience your memory, concentration, and/or planning abilities today compared to before the cardiac arrest?". Health status was measured using the EQ VAS, psychological distress with the Hospital Anxiety and Depression Scale, and overall life satisfaction with the Life Satisfaction checklist. Data were analysed using binary logistic regression.

RESULTS

Among 4026 identified survivors, 1254 fulfilled the inclusion criteria. The mean age was 65.9 years (SD = 13.4) and 31.7% were female. Self-reported cognitive function among survivors was reported as: 'Much worse' by 3.1%, 'Worse' by 23.8%, 'Unchanged' by 68.3%, 'Better' by 3.3%, and 'Much better' by 1.5%. Declined cognitive function was associated with lower health status (OR = 2.76, 95% CI = 2.09-3.64), symptoms of anxiety (OR = 3.84, 95% CI = 2.80-5.24) and depression (OR = 4.52, 95% CI = 3.22-6.32), and being dissatisfied with overall life (OR = 2.74, 95% CI = 2.11-3.54). These associations remained significant after age, sex, place of CA, aetiology, initial rhythm, initial witnessed status, and cerebral performance were controlled.

CONCLUSIONS

Survivors experiencing declined cognitive function post-CA are at a higher risk of poorer health status, increased psychological distress, and reduced life satisfaction, and these risks should be acknowledged by healthcare professionals.

摘要

目的

自我报告的认知功能已被描述为基于表现的测量方法的重要补充,但在心脏骤停(CA)幸存者中很少得到研究。因此,本研究旨在描述自我报告的认知功能及其与健康状况、心理困扰和生活满意度的关联。

方法

本研究使用了瑞典心肺复苏登记处(2018 - 2021年)的数据,这些数据是在心脏骤停后3 - 6个月登记的。认知功能通过一个单一问题进行评估:“与心脏骤停前相比,你今天如何看待自己的记忆、注意力和/或规划能力?”。健康状况使用EQ VAS进行测量,心理困扰使用医院焦虑抑郁量表进行评估,总体生活满意度使用生活满意度清单进行评估。数据采用二元逻辑回归分析。

结果

在4026名确定的幸存者中,1254人符合纳入标准。平均年龄为65.9岁(标准差 = 13.4),女性占31.7%。幸存者自我报告的认知功能情况为:“差得多”占3.1%,“较差”占23.8%,“无变化”占68.3%,“较好”占3.3%,“好得多”占1.5%。认知功能下降与较低的健康状况(比值比 = 2.76,95%置信区间 = 2.09 - 3.64)、焦虑症状(比值比 = 3.84,95%置信区间 = 2.80 - 5.24)和抑郁症状(比值比 = 4.52,95%置信区间 = 3.22 - 6.32)以及对总体生活不满意(比值比 = 2.74,95%置信区间 = 2.11 - 3.54)相关。在控制了年龄、性别、心脏骤停地点、病因、初始心律、初始是否被目击以及脑功能等因素后,这些关联仍然显著。

结论

心脏骤停后认知功能下降的幸存者健康状况较差、心理困扰增加和生活满意度降低的风险更高,医疗保健专业人员应认识到这些风险。

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